WCDefenseCA

Should fertility treatments and vacation-home modifications be covered by California Workers’ Compensation?

In a recent case, Croushorn v. WCAB,  applicant George Croushorn made a claim for over $83,000 in improvements to his vacation home (installing a wheelchair ramp) and over $70,000 in fertility treatments as reimbursable under his 100 percent Permanent Disability and future medical award from 1998.

In 1995, Mr. Croushorn sustained an injury to his spine, legs, arms, head, neurological system, psyche, internal system and shoulders.  The injury was admitted and resulted in a stipulated award.

Defendant cited Labor Code § 4600 taking the position that fertility treatments and vacation-home wheelchair ramps were not “reasonably required to cure or relieve the injured worker from the effects of his or her injury.”  After all, defendant had already modified applicant’s primary residence twice.

The applicant, however, cited the need for a vacation home to treat his psyche symptoms and the need for fertility treatments because the injury had rendered him unable to have children without them.

The result?  The Workers’ Compensation Judge found for the applicant, concluding that the treatments and the wheelchair ramp were both reasonably necessary.  Defendant, not being content with an unnecessary extra $150,000 in benefits to pay out, petitioned for reconsideration.

Although the Workers’ Compensation Appeals Board had no doubt that several expenses could be undertaken to help applicant’s psychiatric condition, the question was whether modifying a vacation home was reasonable – and it was not.

The issue of the home modification was remanded to the WCJ to determine if defendant had, as applicant claims, promised to modify three homes.

On the issue of in vitro fertilization, the WCAB found that defendant must pay for the extraction of applicant’s sperm, but not the in vitro fertilization of his wife.

The Court of Appeals denied applicant’s Petition for a Writ of Review without prejudice to await the determination of the issues sent on remand.

In the past, I’ve seen items from vans with disabled ramps to hot tubs with extra jets to computer games being found reasonably required to cure or relieve the injured worker from the effects of his or her injury.  The reason I post on this case is because I am pleasantly surprised to find at least some sort of limit to what the defendant is burdened with paying for.

What’s the craziest treatment you’ve seen covered by  § 4600?  Let me know – gregory@grinberglawoffice.com